| NPI | 1144709627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WELLS Psychologist 415-800-7083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |